Debating Digital Inclusion- Expanding the Social Determinants of Health to Include Broadband Access

Debating Digital Inclusion- Expanding the Social Determinants of Health to Include Broadband Access

Post 1 Response

Hello,

This is a great post. I agree that digital literacies and internet connectivity can be called the super determinants of health. The term “super social determinants of health” refers to the increasingly recognized influence of digital literacies and internet connectivity on overall health outcomes. Just as traditional social determinants of health, such as education, income, and access to healthcare, significantly impact an individual’s well-being, digital literacies and internet access have emerged as critical factors in shaping health outcomes in the modern world.

One example of this impact is in access to information. Accordingly, the Internet provides access to a vast amount of health-related information. Individuals with digital literacy skills can research symptoms, conditions, and treatment options, empowering them to make informed decisions about their health. Secondly, internet connectivity enables telemedicine services, allowing individuals to consult with healthcare providers remotely (HealthIT.gov. 2018). This is particularly beneficial for those in remote or underserved areas who may have limited access to traditional healthcare facilities. A third example is in health monitoring and wearable technology. Wearable devices and health apps connected to the Internet enable individuals to track their health metrics, such as heart rate, activity levels, and sleep patterns. This data can help people better manage chronic conditions and make healthier lifestyle choices.

Further, another important example of how digital literacies and internet connectivity can impact health is through online support networks. Ashtari and Taylor (2023) conducted a study that showed that patients with extremely rare diseases find important information from online groups that their healthcare providers have no clue about. However, it’s important to note that digital literacy and internet access disparities can exacerbate existing health inequalities. Groups with limited digital skills or inadequate internet connectivity may face barriers to accessing online health resources and telemedicine services, widening the gap in healthcare access and outcomes. Therefore, recognizing the significance of digital literacies and internet connectivity in shaping health outcomes underscores the importance of addressing digital divides and ensuring equitable access to digital resources and technologies for all individuals, regardless of socioeconomic status or geographical location.

References

Ashtari, S., & Taylor, A. (2023). Patients With rare diseases and the power of online support groups: Implications for the medical community. JMIR formative research, 7, e41610.

HealthIT.gov. (2018). What is an electronic health record (EHR)? https://www.healthit.gov/faq/what-electronic-health-record-ehr

Post 2 Response

Hello,

Great work with your post. I concur with you that apart from the traditional key areas of social determinants of health, technology has a huge impact on healthcare and should thus be included in the social determinants of health list. According to Rubinelli and Diviani (2020), health behaviors have up to 30% impact on a person’s mental, physical, and overall well-being. On the other hand, biology and genetics have an estimated 20% impact on the same. As such, there is a need for societal efforts to empower people so that there is better population health. Technology through digital inclusion can empower people to contribute to their own flourishing and work in collaboration with the health system, thus ensuring the success and survival of a healthy society.

To explain further, health promotion and behavior change are crucial components of public health efforts aimed at improving population health outcomes. Digital platforms have emerged as powerful tools for delivering health promotion campaigns, behavior change interventions, and preventive health initiatives (Evans et al., 2019). One example of this is through targeted messaging. Digital platforms allow health promoters to deliver targeted messages to specific audiences based on demographic information, geographic location, or behavioral characteristics. By tailoring messages to the needs and interests of different groups, digital campaigns can effectively capture individuals’ attention and resonate with their motivations and concerns.

A second example is through personalized recommendations. Through data analytics and machine learning algorithms, digital platforms can generate personalized recommendations for individuals based on their health profiles, preferences, and behaviors (Evans et al., 2019). These recommendations may include tailored exercise routines, dietary guidelines, or reminders for health screenings and vaccinations. Personalization increases the relevance and effectiveness of health interventions by addressing individuals’ unique needs and circumstances. Lastly, yet important, is feedback and monitoring. Digital platforms enable real-time feedback and monitoring of individuals’ health behaviors and progress toward health goals. Wearable devices, health-tracking apps, and online dashboards allow users to monitor their activity levels, nutritional intake, sleep patterns, and other health metrics. By providing instant feedback and visualizations of progress, digital tools motivate individuals to stay on track and make informed decisions about their health. By harnessing the power of technology, public health practitioners can reach broader audiences, deliver more impactful interventions, and empower individuals to adopt healthier lifestyles and engage in preventive healthcare practices.

References

Evans, W. D., Thomas, C. N., Favatas, D., Smyser, J., & Briggs, J. (2019). Digital segmentation of priority populations in public health. Health Education & Behavior, 46(2_suppl), 81S-89S.

Rubinelli, S., & Diviani, N. (2020). The basis of targeting behavior in health promotion and disease prevention. Patient education and counseling, 103(12), 2395-2399.

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Transform Wk 8 Discussion Response

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Respond to a colleague whose views differed from yours on whether digital inclusion of broadband access should be added as a key area to the social determinants of health. Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on the readings.
• Respond to a colleague who discussed a different health IT system than you did. Share an insight from having read your colleagues’ posts, synthesizing the readings to provide new perspectives on how the system can impact or be impacted by the social determinants of health.
  

  Debating Digital Inclusion- Expanding the Social Determinants of Health to Include Broadband Access

*Note: Throughout this program, your fellow students are referred to as colleagues.

POST 1

The use of digital tools and applications is steadily increasing and can support a range of health information needs. As tools such as patient portals, health trackers, and remote monitoring devices see greater use, research suggests that tools such as health apps and patient portals can foster greater patient engagement, better support for patients outside of clinic visits, and can improve health outcomes. However, greater reliance on digital tools has the potential to increase disparities between those who have skills and access to digital tools and those who do not and thereby existing health disparities.

Digital literacies and Internet connectivity have been called the “super social determinants of health” because they address all other social determinants of health (SDOH)(Gordon WJ et al, 2020). For example, applications for employment, housing, and other assistance programs, each of which influences an individual’s health, are increasingly, and sometimes exclusively, accessible online. The costs of equipping a person to use the Internet are substantially lower than treating health conditions and the benefits are persistent and significant, making the efforts to improve digital literacy skills and access valuable tools to reduce disparities.

Regular hospital visits can be expensive, particularly in rural areas, due to travel costs. In the era of the COVID-19 pandemic, where physical interaction becomes risky, people prefer telemedicine. Fortunately, medical visits can be reduced when telemedicine services are used through video conferencing or other virtual technologies. Thus, telemedicine saves both the patient’s and the healthcare provider’s time and the cost of the treatment. Furthermore, due to its fast and advantageous characteristics, it can streamline the workflow of hospitals and clinics. This disruptive technology would make it easier to monitor discharged patients and manage their recovery. As a result, it is sufficient to state that telemedicine can create a win-win situation.

Using health apps for scheduled follow-up visits makes doctors and patients more effective and improves the probability of follow-up, reducing missing appointments and optimizing patient outcomes(Wilson L.S., 2015). Patients should have an accurate medical history and show the doctor any prominent rashes, bruises, or other signs that need attention through the excellent quality audio-video system. Further, practitioners need file management and a payment gateway system. Telemedicine technologies allow patients and doctors to review the treatment process. However, this technology supplements physical consultation and is in no way a substitute for physical consultation. Today this technology is a safe choice for patients who cannot go to the doctor or sit at home, especially during a pandemic.

References:

Gordon WJ, Landman A, Zhang H, Bates DW. Beyond validation: getting health apps into clinical practice. npj Digit. Med. 2020

Wilson L.S., Maeder A.J. Recent directions in telemedicine: review of trends in research and practice. Healthcare informatics research. 2015 Oct;21

POST 2

The concept of social determinants of health highlights that health outcomes are influenced not only by individual behaviors and genetics but also by broader social, economic, and environmental factors (Sieck et al., 2021). The traditional key areas, known as walkability, include economic stability, education, social and community context, healthcare access, and neighborhood and built environment (Baobeid et al., 2021). However, as technology plays an increasingly significant role in healthcare, the question becomes apparent whether digital inclusion or broadband access should be added to these critical areas.

I believe digital inclusion and broadband access are essential components that should be considered as critical social determinants of health. The digital divide, where specific populations lack access to digital technologies and the internet, can exacerbate health disparities (Dijk, 2020). For example, individuals with internet access may need help accessing telemedicine services, online health information, or electronic health records (EHRs), putting them at a disadvantage in managing their health (Dijk, 2020).

Digital inclusion is essential for ensuring that everyone has equal access to health information and services, regardless of socioeconomic status. In 2016, the United Nations General Assembly pronounced that access to the internet is a human right; therefore, everyone should have it (Sanders & Scanlon, 2021). It goes beyond the connectivity of care and encompasses the ability to use and benefit from digital technologies effectively. With digital inclusion, individuals may benefit from health promotion campaigns, online education about chronic diseases, or remote monitoring tools that can enhance preventive care, care coordination, and patient involvement.

The impact of electronic health records, mobile health, patient portals, and Telemedicine on social determinants of health is significant. Depending on how they are implemented, these technologies can alleviate and exacerbate health disparities (Carini et al., 2021). First, EHRs can improve care coordination, enhance communication between healthcare providers, and streamline health information. However, disparities may arise if specific populations need access to digital health records or face barriers to understanding and navigating these systems. According to research, 15-24% of Americans do not have any broadband connection, and that number only increases in lower-income families, with upwards of 38% not having access (Sieck et al., 2021). Secondly, mobile apps for health monitoring, medication reminders, and wellness programs can empower individuals to take charge of their health. However, those who have smartphones or reliable internet access may be included in these benefits. Thirdly, patient portals allow individuals to access their health information, schedule appointments, and communicate with healthcare providers.

Nevertheless, if someone needs the digital literacy or broadband access needed to use these portals, they may miss out on engaging with their healthcare. Lastly, Telemedicine offers remote access to healthcare services, which is especially valuable for individuals in rural or underserved areas. However, the effectiveness of Telemedicine is limited to those with access to high-speed internet.

In conclusion, digital inclusion and broadband access are integral to addressing social determinants of health in the modern era. Failing to consider these factors can cause health injustices (Rodriguez et al., 2020). Policymakers, healthcare providers, and technology developers must work collaboratively to ensure that advancements in digital health benefit all population segments, regardless of their socioeconomic status or geographical location.

References

Baobeid, A., Koç, M., & Al-Ghamdi, S. G. (2021). Walkability and its relationships with health, sustainability, and livability: Elements of physical environment and evaluation frameworks. Frontiers in Built Environment, 7. https://doi.org/10.3389/fbuil.2021.721218Links to an external site.

Carini, E., Villani, L., Pezzullo, A., Gentili, A., Barbara, A., Ricciardi, W., & Boccia, S. (2021). The impact of digital patient portals on health outcomes, system efficiency, and patient attitudes: Updated systematic literature review. Journal of Medical Internet Research, 23(9), e26189. https://doi.org/10.2196/26189Links to an external site.

Dijk, J. Van. (2020). The digital divide. John Wiley & Sons.

Rodriguez, J. A., Clark, C. R., & Bates, D. W. (2020). Digital health equity as a necessity in the 21st century cures act era. JAMA, 323(23), 2381. https://doi.org/10.1001/jama.2020.7858Links to an external site.

Sanders, C. K., & Scanlon, E. (2021). The digital divide is a human rights issue: Advancing social inclusion through social work advocacy. Journal of Human Rights and Social Work, 6(2), 130–143. https://doi.org/10.1007/s41134-020-00147-9Links to an external site.

Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of health. npj Digital Medicine, 4(1). https://doi.org/10.1038/s41746-021-00413-8Links to an external site.